Chronic Obstructive Pulmonary Disease (COPD) (cont.)

Medical Author:
Medical Editor:

What else is available for treating COPD?

Pulmonary rehabilitation has become a cornerstone in the management of moderate to severe COPD. Pulmonary rehabilitation is a program of education regarding lung function and dysfunction, proper breathing techniques (diaphragmatic breathing, pursed lip breathing), and proper use of respiratory equipment and medications. An essential ingredient in this program is the use of increasing physical exercise to overcome the reduced physical capacity that usually has developed over time. In addition, occupational and physical therapy are used to teach optimal and efficient body mechanics.

Lung volume reduction surgery (LVRS) has received much fanfare in the lay press. LVRS is a surgical procedure used to treat some patients with COPD. The premise behind this surgery is that the over-inflated, poorly-functioning upper parts of the lung compress and impair function of the better-functioning lung elsewhere. Thus, if the over-inflated portions of lung are removed surgically, the compressed lung may expand and function better. In addition, the diaphragm and the chest cavity achieve more optimal positioning following the surgery, and this improves breathing further.

The best criteria for choosing patients for LVRS are still uncertain. A national study was completed in 2003. Patients primarily with emphysema at the top of their lungs, whose exercise tolerance was low even after pulmonary rehabilitation, seemed to do the best with this procedure. On average, lung function and exercise capacity among surviving surgical patients improved significantly following LVRS, but after two years returned to about the same levels as before the procedure. Patients with forced expiratory volume in FEVI of less than 20% of predicted and either diffuse disease on the CT scan or lower than 20% diffusing capacity or elevated carbon dioxide levels had higher mortality. The role of LVRS is at present is very limited.

Medically Reviewed by a Doctor on 5/13/2013

Patient Comments

Viewers share their comments

Chronic Obstructive Pulmonary Disease - Symptoms Question: The symptoms of chronic obstructive pulmonary disease can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Chronic Obstructive Pulmonary Disease - Treatments Question: What treatment has been effective for your COPD?
Chronic Obstructive Pulmonary Disease - Causes Question: What was the cause of your COPD?
Chronic Obstructive Pulmonary Disease - Experience Question: Were you, a friend, or relative diagnosed with COPD? Please share your experience.